Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Int J Womens Health. 2011;3:277-80. doi: 10.2147/IJWH.S20387. Epub 2011 Aug 12.
Reproductive health researchers are interested in finding better methods for predicting an unwanted type of delivery after induction of labor. The aim of this study was to compare the value of transvaginal ultrasonography findings and the Bishop score in predicting cesarean section after induction of labor.
Two hundred women with singleton pregnancies undergoing induction of labor at 37-42 weeks were enrolled in this prospective study. Transvaginal investigation was done for all participants prior to induction. To compare the predictive value of the methods, receiver-operating characteristic (ROC) curves were plotted and equality of the area under curve (AUC) was tested.
The mean age of the participants was 29.9 years, mean gestational age was 39.6 weeks, and mean gravid was 1.5. The AUC calculated for Bishop score was 0.39 (95% confidence interval [CI] 0.3-0.48). The AUC for cervical length measured by ultrasonography was 0.69 (95% CI 0.6-0.77). The AUC for the posterior cervical angle measured by ultrasonography was 0.38 (95% CI 0.29-0.47). Testing equality of the ROC curves for these three methods showed the ROC for cervical length to be statistically different from both Bishop score and posterior cervical angle (P < 0.001). However, the difference in ROC area compared between Bishop score and posterior cervical angle was not statistically significant.
Based on our findings and available information in the literature, it seems that cervical length measured by transvaginal ultrasonography has the potential to replace the traditional Bishop score, provided that such a facility is available when needed.
生殖健康研究人员有兴趣寻找更好的方法来预测引产后的不良分娩类型。本研究旨在比较经阴道超声检查结果和 Bishop 评分在预测引产后的剖宫产中的价值。
本前瞻性研究纳入了 200 名 37-42 周单胎妊娠接受引产的女性。所有参与者在引产前均进行经阴道检查。为了比较这些方法的预测价值，绘制了受试者工作特征（ROC）曲线，并检验了曲线下面积（AUC）的均等性。
参与者的平均年龄为 29.9 岁，平均妊娠周数为 39.6 周，平均孕次为 1.5 次。Bishop 评分的 AUC 为 0.39（95%置信区间 [CI] 0.3-0.48）。经阴道超声测量的宫颈长度的 AUC 为 0.69（95%CI 0.6-0.77）。经阴道超声测量的后宫颈角的 AUC 为 0.38（95%CI 0.29-0.47）。对这三种方法的 ROC 曲线进行均等性检验表明，宫颈长度的 ROC 曲线与 Bishop 评分和后宫颈角均有统计学差异（P < 0.001）。然而，Bishop 评分和后宫颈角的 ROC 曲线之间的 AUC 差异无统计学意义。
根据我们的发现和文献中的现有信息，似乎经阴道超声测量的宫颈长度有可能取代传统的 Bishop 评分，前提是在需要时能够提供这种设施。
